Permit Y
IN CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00364
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2007
PARCEL: 1 S134DC -04600
SITE ADDRESS: 11675 SW 113TH PL ZONING: R -4.5
SUBDIVISION: MUTTLEYS ADDITION LOT: 003 JURISDICTION: TIG
PROJECT: COX
Project Description: Install furnace and a/c units.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JEFFERY & KENDYL COX Description Date Amount
11675 SW 113TH PL
TIGARD, OR 97223 [MECH] Permit Fee 6/19/200 $72.50
[TAX] 8% State Surcha 6/19/200 $5.80
Total $78.30
Phone: 503 - 598 -9935
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 261 -9915
FAX 503- 261 -9814
Reg #: LIC 122424
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B I P Signature: AO (' �
/i /./ / i / . / . p
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jun 19 2007 12:33PM HEAT RELIEF Heating & Coo 503 261 9814 p. 2
4echanical Permit Application - : � 1 t)1. O1 l It 1 1 tit 4 )11 \
city of Tigard ritUEI Vg ' Received
Date/By: O / �� Permit Na. A A : e� _
S 125 SW Hall Blvd., Tigard, OR 97223
D an Rov w 1" U 7 e
lone: 503.639.4171 Fax: 503.598.1960 JUN 1 9 Date/By: Other Pernik:
s co line: 503.
on 03.639.4175 s'
�t met: Line: 5 d.or.u5 - s.;' ' I � Date ReadyBy: 2urv: Bf See Page 2 for
CITY OF ■ t T;:' T;:' Notifled/ 16' Suppkmeotal
r5 j
] New construction ►� - ddition /aiteration/replacement Mechanical permit fees' are based on the of the work
] Demolition performed. Indicate the value (rounded to the nearest dollar) or a
❑ 0 en': mechanical materials, equipment, labor, overhead, and profit.
i { ''..) ' - ; I. Value; S
)- and 2- familydwelling ❑Con nercial /indiesti-ia) ce
❑ At y llo ry buii ding „ �:E r K h ' .
] Multi- family ❑ Master builder 0 Other; For specie! information usechecklest.
t r° . Description Qty Total
.ice ,till . i. i .;'. 7 I .. ` r r 1 • .. ' k i 3 t �: Q�
... :, , ,.. Heating/cooling
ob site address: 5 4.4j. „1 ! ? Yta4,ve
(requires site plan shoo/mg Air conditioning or heat pump
s: i 9 6
'ity /S1aaddres placemeni) 14.00 1141.00 7-',. a.( c 1 ,72- Furnace 100,000 BTU iducts/vcnu) ( 1 4.00 14. 60
iuite/hldglapt. no.: Project name: Furnace 100,000+ BTU (duets/vents) 17.90
Gas heat pump 14.00
'ross street/directions to job site: Duct work 1400
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) t4
Unit heaters (fuel -type, not electric),
in-wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
iubd tiision: 1.0t no.:
Other: 10.00
fax map/parcel no.: Other fuel appliances
A "' Water heater 10.00
O Gas fireplace 10.00
S 11 S .l I KU 10 T-{ /y t - A ) e 'i -1.e)„-- Flue vent for water heater or gas
- aD- '9"J fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
3+ ti� . " .; Chimney/liner/flue/went _ 10.00 _
� Other _ 10.00
r
Name: e . r __ c2y Environmental exhaust and ventilation
Address: t (/) S wJ
-k-'- �/� Range hood /other kitchen
:ay/State/ZIP: 7•- equipment 10.00
T. � ?•=g Clothes dryer exhaust 10.00
Phone ( ?) F ax: ( )
Single -duct exhaust (bathrooms,
(r: r , to' et compartments, utility rooms) 6.80
c ?�i M' -. :, : ,. . • Attic /crawispace fans
10.00
Business name: 4 064,4 Q� Cie_-�Q Other: 10.00
P ^T Fuel piping
Contact name: ry ekrK .L Q
1� $5.40 for first four; 51.00 for each additional
Address: 1312-2 ii -DAV ( 6� � 41 26 Furnace, etc.
urZlP: lJ Sl - Gas heat pump
City /Sta
Pr r414I , o `11;-30 Wail/suspended /unit heater
Phone: (511 ) -i -- gq i s I pax:: (58 )e.1-C -Caif f Water heater
E-mail: 7 Fireplace
as 4 I,-_4: n s Mi f.• . • a >L
�,� Range
k " a. _t .,... •,,i•;l rij Barbecue
Business name: iZ2ne_S- Clothes dryer (gas)
Addr 31 Other
22 �4 v; G e..$u17e - 4 got >; , , ir .
- � :`;."' l r 8.
City /State /ZIP:
q nt^,t . C1rZ 9 ?33 0 8ubtotai • Zb • 60
Phone: ( ) ,..4 f..� C1 1 t] -- I Fax: (- ) �r�atIy Minimum permit fee (S72.50) 1- ,a- Q
CCB lie,: 1 a-aLf,L / 4 -121 1Oa `�\ P a review(2 % ofpemkii fee)
7 I State surcharge (2% of permit fee) S--. t p
TOTAL PERMIT FEE - 1 K, 30
Authorized signature: Li 1 /
This permit application eiplrea If a perm!' is not obtained within tat
� a y /��t
days after it has bun accepted is complete.
a
Print name: p\rK. .ta " .r r �7A
AcA- C o Ditto: (0 (L / 6 • Fee methodology set by Tri- Ca'aty Building industry Service Board
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A/C -HEAT PUMP—UNIT SITE PLAN
FEET TO BACK OF PROPERTY LINE W 4 ' )
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EET TO SIDE PROPERTY LINE
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FEET TO FRONT PROPER' TY LINE
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o 'n PLEASE REFAX APPLICAT1 N WITH SITE PLAN
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CITY OF TIGARD • rnG
BUILDING DIVISION PERMIT #: ✓7, t
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 .o Al
Inspection Requests (24 Hrs.): (503) 639 -4175 JJ :......„ --- INSPECTION WORKSHEET FOR DATE: /// 3 / v7 TIME: PAGE:
SITE ADDRESS: / (1 ' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: /.../. P
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Pt &el
Corrections /Comments /Instructions:
1
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X PASS ❑ PARTIAL APPROVAL ❑ CANCEL [ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date f Di Phone #: (503) 718-